Basic Information
| Provider Information | |||||||||
| NPI: | 1144524786 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DOCTOR'S OFFICE OF WEST CALDWELL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 484 TEMPLE HILL RD | ||||||||
| Address2: | SUITE 102 | ||||||||
| City: | NEW WINDSOR | ||||||||
| State: | NY | ||||||||
| PostalCode: | 125535557 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8455653700 | ||||||||
| FaxNumber: | 8455653696 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 BLOOMFIELD AVE | ||||||||
| Address2: | WEST CALDWELL PLAZA | ||||||||
| City: | WEST CALDWELL | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 070066700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9738082273 | ||||||||
| FaxNumber: | 9738082287 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/22/2010 | ||||||||
| LastUpdateDate: | 04/06/2016 | ||||||||
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| AuthorizedOfficialLastName: | RUVO | ||||||||
| AuthorizedOfficialFirstName: | ANTHONY | ||||||||
| AuthorizedOfficialMiddleName: | R | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 8455653700 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.